St. Helen First Communion

St. Helen First Communion

Registration
Child's Name*

First Name (as you want it to appear on certificate)Middle NameLast Name
Date of Birth*

MonthDayYear
Date
T-shirt size*
Child Attends*
Church of Baptism-If not baptized at St Helen you must submit a Baptismal Certificate*
Include Church Name, City & State
Date of baptism*

MonthDayYear
Date
Father's Name*

First NameLast Name
Father's Religion
Mother's Name *

First NameMAIDEN Name
Mother's Religion
Address*

Street Address

Street Address Line 2

Citystate

Postal / Zip Code
Primary Email*
example@example.com
Primary Phone Number*
Please enter a valid phone number.
Any Allergies or Medical Conditions?*

YesNo
Please give details
Payment Information

Payment of $50 is due on or before our First Communion meeting on Oct 18th. You can pay by check to Church of St Helen or though On-Line Giving. If you choose on-line giving, after you submit this form you will be directed to the website to complete payment.
I intend to pay by*
I, undersigned, agree with the following statements:*

I am the parent/guardian of the child indicated above.I am giving my permission to take my child's pictures for classroom projects and post them on the church website.I intend to pay on or before Oct 18th 2023
Date*

MonthDayYear
Date
Signature*

Clear
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